CBT For CBT

Question

I hope you’ll be able to help me, even though I’m running out of hope. I am a 36-year-​old straight man, mostly monogamous. About eight months ago I had a one-​night stand with a 35-​year-​old woman. There was no complete sex, just some fingering, and she gave me oral sex.

I was absolutely okay until I saw I saw her again a month later to supposedly go all the way. It didn’t happen because when we were in the middle of foreplay and kissing, she told me she’d had herpes about 10 years ago. By the way, I’d previously asked her more than five times if she’d ever had an STI, and she always said no. I was shocked by the news.

She said the doctor at that time had given her the diagnosis after a visual exam and she’d never had a blood test or any other test. She’s not promiscuous and just a few months before our date she was tested for STIs (except HV2), and the results were negative. According to her, she seldom has any symptoms of the disease, just some sensitivity in the genital area.

The day after our second encounter I started having some tingling, itching and burning sensations in the genital area, but no visual symptoms. I went to the doctor three weeks later, and he told me I that I had nothing. He ordered some blood tests, which all came out negative.

I have seen other five doctors since, and they all tell me that I have nothing and that my symptoms are probably psychosomatic, caused by my fear of STIs. One said I could have some kind of a virus that can’t be detected through lab tests, and that mine’s not the only case he’s seen with these symptoms. Another told me maybe I should see a shrink.

I’ve been tested for HIV, hepatitis B and C, gonorrhea, chlamydia, syphilis, herpes 2 – for some of them up to three times – and all tests have come out negative. The doctors don’t see any fungi or allergic reactions.

I’m living a nightmare. My personal life has been seriously affected: I still have the same symptoms and I don’t feel like having sex because it also hurts. I’ve lost almost all hope of ever having a normal genital area again, i.e., without itching, burning and sensitivity. Can you please help me?

Answer

It seems to me that you’re more running out of logic more than of hope, Burning, so let’s try to restore that quality before you lose it completely.

I can’t help but indulge in a good Muttley snicker (youtube.com/watch?v=SKm5xQyD2vE) at the acronym CBT. In the psychiatric world it stands for cognitive behavioural therapy, while in the world of BDSM it’s cock and ball torture. In your case, you are going to need some CBT for your self-​inflicted CBT. Here is a website where you can download what’s known in cognitive behavioural therapy as a thought record: cognitivetherapyguide.org/thought-​records.htm.

I’ll show you an example of how to fill a few of the sections out:

1. The situation. Briefly describe the situation you would like to have handled better:

“I didn’t have sex with someone, who later revealed she had an STI for which she’d actually never been tested, though she’d had thorough examinations for every other one going, all of which were negative. The only way I could have contracted this particular virus is by having vaginal sex with her, which, again, I did not do.

“The way that this virus (which I couldn’t have possibly contracted given my activities) seems to be manifesting on me is in ways it’s never manifested in the history of humanity. I have seen five doctors, had three batteries of thorough tests, none of which have revealed any STI.

“One doctor told me about some vague, unnamed virus he’s seen before that cannot be detected in lab tests. I’ve chosen to prioritize this nebulous and untenable information over the information provided by four other doctors because negative information is always more authentic than positive information.”

2. Initial thought. What thought first popped into your mind?

“Having an STI means I will become a social pariah and never have sex again. I think STIs are disgusting, and therefore I am disgusting if I have one. I am obsessed with this over all other infections that routinely afflict my body, including colds and flus. Even if this STI is not fatal, it signals the death of my virility and viability as a sex partner. Since I would never sleep with someone who has an STI, I expect to be treated with the same lack of grace and rationality.”

The thought record then guides you to wonder about the consequences of your current thinking (for example, making yourself sick with worry and not having sex as a result), encourages you to think more positively and guides you to make action plans.

And my completely non-​professional opinion about the itching, burning and sensitivity? That’s your cock, in the style of Gogol’s The Nose, trying to detach itself from you so it can go and get fucked, free from your relentless spectre of panic.